The review you are about to read comes to you courtesy of H-Net --
its reviewers, review editors, and publishing staff. If you
appreciate this service, please consider
donating to H-Net
so we can continue to provide this service free of
charge.

Prefer another language? Translate this review into

Please note that this is an automated translation, and the quality
will vary.

While the role of physicians in National Socialist crimes against humanity has been explored in great depth in the past few decades, only more recently have scholars started examining the field of medical ethics under Nazism. Florian Bruns's book is a sound and important piece of scholarship that confirms the recent work of Andreas Frewer and other historians, while providing compelling evidence to support the position of Claudia Koonz and myself that, rather than ignoring ethics, Nazi ideology was permeated with ethical concerns.[1]

Considering the immoral behavior of many physicians in Nazi Germany, one might expect that Nazi officials and physicians would have spurned medical ethics. On the contrary, however, the regime and its physicians were intensely interested in medical ethics; they even revised the medical curriculum in 1939 to mandate courses covering the subject. One reason Nazi officials were so enthusiastic was the acceptance among many physicians in Germany, by the 1920s and 30s, of a collectivist ethic that endorsed eugenics and sometimes even involuntary euthanasia as public health measures to improve the health of the German Volkskörper. Bruns explains that Social Darwinism and eugenics played a crucial role in shaping this new medical ethic.

At the heart of Bruns's study lies an examination of three physicians who promoted Nazi medical ethics at universities and in publications: Bernward Josef Gottlieb, Rudolf Ramm, and Joachim Mrugowsky. All three were Nazis living in Berlin (though Gottlieb transferred to Graz from 1943 to 1945) and acquainted with some of the highest-ranking Nazi leaders. All three belonged to the SS, though Ramm resigned in 1937. (Bruns does not explain why.) Ramm was the most politically active, serving as a Nazi Reichstagmember even before 1933. By 1941, Ramm held a high position in the Health Office and also edited two major medical journals, in addition to teaching classes on medical ethics at the University of Berlin. Gottlieb, a historian of medicine, helped found the SS Institute for the History of Medicine in 1941, before transferring to Graz in 1943 to teach at the SS Physicians' Academy. Mrugowsky served as the leading hygienist for the SS, and began teaching hygiene at the University of Berlin in 1939. He was the only one to participate directly in Nazi atrocities; he supervised and sometimes directly carried out deadly human experimentation. Both Mrugowsky and Ramm were executed for their roles in the regime. Gottlieb, however, taught at the University of the Saarland from 1956 to 1964 before resigning because of his Nazi past.

Though many of Bruns's findings confirm other historians' work, one surprise he uncovers is the role of Hippocrates in Nazi medical ethics. Gottlieb published--with a foreword by Heinrich Himmler--excerpts from the Hippocratic corpus. Tellingly, he excluded the Hippocratic Oath and reinterpreted Hippocrates in light of collectivist ethics. Many leading Nazi physicians concurred with Gottlieb, portraying Nazi medical ethics as a continuation of Hippocrates. Others, such as Ramm, argued that Nazi medical ethics made a radical break from previous forms of ethics. Mrugowsky argued that medical ethics change over time, and he wanted to replace Christian ethics with principles focused on the primacy of the German people. Though all three physicians agreed on the general contours of medical ethics and supported Nazi racial doctrines, they did not agree on everything. In his textbook, Ärztliche Rechts- und Standeskunde (1942), Ramm argued explicitly for the propriety of killing the disabled, which the Nazis had been doing secretly since 1940. Mrugowsky, on the other hand, argued against assisted suicide and euthanasia in his 1939 book on medical ethics. No evidence suggests, however, that Mrugowsky had any qualms about killing people, since he supervised lethal human experiments.

In Nazi medical ethics anything was justified if it served the "higher" goal of the German people. This enlightening study demonstrates that the Nazis did not jettison ethics in order to commit atrocities. Rather, they followed a collectivist ethic that exalted the German people above individuals and other races.